Journal of Emergency Medicine最新文献_第4页

American Academy of Emergency Medicine 美国急诊医学学会

IF 1.2 4区医学

Journal of Emergency Medicine Pub Date : 2024-08-01 DOI: 10.1016/S0736-4679(24)00225-7

引用次数: 0

The Lipliner Sign: Potential Cause of a False Positive Focused Assessment with Sonography in Trauma (FAST) Examination. Lipliner征：创伤超声聚焦评估（FAST）检查假阳性的潜在原因。

IF 1.2 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-28 DOI: 10.1016/j.jemermed.2024.06.013

Maria A Parker, Bryson G Hicks, Matt Kaili, Aaron Silver, Meihua Zhu, Magdelyn Feuerherdt, Yuan Zhang, Caelan Thomas, Cynthia R Gregory, Kenton W Gregory, Nikolai Schnittke

{"title":"The Lipliner Sign: Potential Cause of a False Positive Focused Assessment with Sonography in Trauma (FAST) Examination.","authors":"Maria A Parker, Bryson G Hicks, Matt Kaili, Aaron Silver, Meihua Zhu, Magdelyn Feuerherdt, Yuan Zhang, Caelan Thomas, Cynthia R Gregory, Kenton W Gregory, Nikolai Schnittke","doi":"10.1016/j.jemermed.2024.06.013","DOIUrl":"10.1016/j.jemermed.2024.06.013","url":null,"abstract":"Background: The focused assessment with sonography in trauma (FAST) examination plays an essential role in diagnosing hemoperitoneum in trauma patients to guide prompt operative management. The FAST examination is highly specific for hemoperitoneum in trauma patients, and has been adopted in nontrauma patients to identify intraperitoneal fluid as a cause of abdominal pain or distension. However, causes of false positive FAST examinations have been described and require prompt recognition to avoid diagnostic uncertainty and inappropriate procedures. Most causes of false positive FAST examinations are due to anatomic mimics such as perinephric fat or seminal vesicles, however, modern ultrasound machines use a variety of postprocessing image enhancement techniques that can also lead to novel false positive artifacts.Case report: We report cases where experienced clinicians incorrectly interpreted ultrasound findings caused by a novel mimic of hemoperitoneum: the \"lipliner sign.\" It appears most prominently at the edges of solid organs (such as the liver and the spleen), which is the same location most likely to show free fluid in FAST examination in trauma patients. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Clinicians who take care of trauma patients must be familiar with causes of false positive FAST examinations that could lead to a misdiagnosis of hemoperitoneum.","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anoxic Brain Injury: A Subtle and Often Overlooked Finding in Non-Fatal Intimate Partner Strangulation. 缺氧性脑损伤：非致命性亲密伴侣勒杀中一个微妙且常被忽视的发现。

IF 1.2 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-25 DOI: 10.1016/j.jemermed.2024.06.006

Sean Dugan, Michelle Patch, Taman Hoang, Jocelyn C Anderson

{"title":"Anoxic Brain Injury: A Subtle and Often Overlooked Finding in Non-Fatal Intimate Partner Strangulation.","authors":"Sean Dugan, Michelle Patch, Taman Hoang, Jocelyn C Anderson","doi":"10.1016/j.jemermed.2024.06.006","DOIUrl":"https://doi.org/10.1016/j.jemermed.2024.06.006","url":null,"abstract":"Background: A paucity of literature exists dedicated to the identification of anoxic brain injury in patients that survive non-fatal intimate partner strangulation (NF-IPS). While some individuals report experiencing symptoms of brain hypoxia followed by a loss of consciousness, other individuals report symptoms of brain hypoxia prior to amnesia, rendering some unable to recall loss of consciousness (LOC).Objective: Using a standardized clinical assessment tool, the purpose of this retrospective analysis is to describe anoxic brain injury symptom prevalence in a sample of patients reporting NF-IPS.Methods: One hundred and ninety-one unique patients, reporting a total of 267 strangulation events, were assessed by a member of the Shasta Community Forensic Care Team utilizing the Strangulation Hypoxia Anoxia Symptom TBI Assessment (SHASTA) tool. The sample is 98% female and includes adult patients ages 18-68. Examination records were categorized based on the presence or absence of hypoxia and anoxia symptoms. This manuscript utilizes the STROBE checklist.Results: Amnesia was reported in 145 of the 267 strangulations (54.3%). Of those, 74 reported LOC (51.0%) while 71 did not recall LOC (49.0%).Conclusions: Within our sample, 49% of patients with amnesia did not recall losing consciousness, demonstrating that LOC is an imperfect measure of anoxia for patients following NF-IPS. Healthcare providers examining NF-IPS patients should inquire about additional symptoms of hypoxia and amnesia, which can be captured on the SHASTA tool.","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Parasite Living Beneath the Conjunctiva. 生活在结膜下的寄生虫

IF 1.2 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-25 DOI: 10.1016/j.jemermed.2024.05.014

Mark Curato, Anfei Li

引用次数: 0

Selective Use of Positive-Pressure Ventilation for Preoxygenation During Air Medical Rapid Sequence Intubation. 在空中医疗快速插管过程中选择性使用正压通气进行预氧。

IF 1.2 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-20 DOI: 10.1016/j.jemermed.2024.06.011

Alexandra Herndon, Kira Chandran, Daniel P Davis

{"title":"Selective Use of Positive-Pressure Ventilation for Preoxygenation During Air Medical Rapid Sequence Intubation.","authors":"Alexandra Herndon, Kira Chandran, Daniel P Davis","doi":"10.1016/j.jemermed.2024.06.011","DOIUrl":"https://doi.org/10.1016/j.jemermed.2024.06.011","url":null,"abstract":"Background: Preoxygenation is critical to safe performance of rapid sequence intubation (RSI). The use of positive-pressure ventilation (PPV) has been advocated during preoxygenation but may increase the risk of aspiration.Objective: To explore the risk-benefit analysis of using PPV during air medical RSI.Methods: We performed a retrospective analysis of the Air Methods Airway Registry using patient data from over 175 bases across the U.S. over a 5-year period. Patients were separated into normoxemic (SpO2 ≥93%) and hypoxemic (SpO2 <93%) and compared in regard to demographics, clinical data, and use of PPV. Primary outcomes were first-attempt intubation success (FAS) and FAS without desaturation (FASWD). Chi-square, t-test, and logistical regression were used to analyze the data.Results: There were 9778 patients who underwent intubations during the study period. FAS was 92% (8966 patients). FASWD was 90% (8775 patients). Mean SpO2 was 94.9%. There were 42% (4118 patients) of patients who received PPV prior to intubation and 1% (94) aspirated during RSI. Multivariate logistical regression showed an association between use of PPV and reduced intubation success for normoxemic patients but improved intubation success for hypoxemic patients. The use of PPV was associated with higher risk of aspiration events (p = 0.007).Conclusion: The use of PPV during preoxygenation prior to RSI appears beneficial for hypoxemic but not normoxemic patients due to lower intubation success and increased aspiration risk with PPV. This data supports selective use of PPV prior to the initial intubation attempt in patients undergoing RSI.","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between Emergency Medical Services Intervention Volume and Out-of-Hospital Cardiac Arrest Survival: A Propensity Score Matching Analysis. 紧急医疗服务干预量与院外心脏骤停存活率之间的关系：倾向得分匹配分析。

IF 1.2 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-19 DOI: 10.1016/j.jemermed.2024.06.008

Thomas Vincent, Tiphaine Lefebvre, Mikaël Martinez, Guillaume Debaty, Cyril Noto-Campanella, Valentine Canon, Karim Tazarourte, Axel Benhamed

{"title":"Association Between Emergency Medical Services Intervention Volume and Out-of-Hospital Cardiac Arrest Survival: A Propensity Score Matching Analysis.","authors":"Thomas Vincent, Tiphaine Lefebvre, Mikaël Martinez, Guillaume Debaty, Cyril Noto-Campanella, Valentine Canon, Karim Tazarourte, Axel Benhamed","doi":"10.1016/j.jemermed.2024.06.008","DOIUrl":"https://doi.org/10.1016/j.jemermed.2024.06.008","url":null,"abstract":"Background: Out of hospital cardiac arrest (OHCA) survival rates are very low. An association between institutional OHCA case volume and patient outcomes has been documented. However, whether this applies to prehospital emergency medicine services (EMS) is unknown.Objectives: To investigate the association between the volume of interventions by mobile intensive care units (MICU) and outcomes of patients experiencing an OHCA.Methods: A retrospective cohort study including adult patients with OHCA managed by medical EMS in five French centers between 2013 and 2020. Two groups were defined depending on the overall annual numbers of MICU interventions: low and high-volume MICU. Primary endpoint was 30-day survival. Secondary endpoints were prehospital return of spontaneous circulation (ROSC), ROSC at hospital admission and favorable neurological outcome. Patients were matched 1:1 using a propensity score. Conditional logistic regression was then used.Results: 2,014 adult patients (69% male, median age 68 [57-79] years) were analyzed, 50.5% (n = 1,017) were managed by low-volume MICU and 49.5% (n = 997) by high-volume MICU. Survival on day 30 was 3.6% in the low-volume group compared to 5.1% in the high-volume group. There was no significant association between MICU volume of intervention and survival on day 30 (OR = 0.92, 95%CI [0.55;1.53]), prehospital ROSC (OR = 1.01[0.78;1.3]), ROSC at hospital admission (OR = 0.92 [0.69;1.21]), or favorable neurologic prognosis on day 30 (OR = 0.92 [0.53;1.62]).","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on Modified PECS II Block for Axillary Hidradenitis Suppurativa 关于治疗腋窝化脓性扁桃体炎的改良 PECS II 阻滞的评论

IF 1.5 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-14 DOI: 10.1016/j.jemermed.2024.03.007

Michael Shalaby MD , Raghav Sahni DO

引用次数: 0

Response to Comment on Cryoneurolysis of Intercostal Nerve for Rib Trauma and Intercostal Neuralgia in the Emergency Department 对 "急诊科肋骨外伤和肋间神经痛的肋间神经冷冻术 "评论的回应

IF 1.5 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-14 DOI: 10.1016/j.jemermed.2024.02.005

Mani Hashemi MD , S.M. Mahmood MD , Jorge Fernandez MD , IV John J. Finneran MD , Jessica Oswald MD, MPH

引用次数: 0

Modified PECS II Block for Axillary Hidradenitis Suppurativa 治疗腋窝化脓性扁桃体炎的改良 PECS II 阻滞疗法

IF 1.5 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-14 DOI: 10.1016/j.jemermed.2024.02.013

Amiya Kumar Barik DM , Anju Gupta MD , Chitta Ranjan Mohanty MD , Rakesh Vadakkethil Radhakrishnan MSN

引用次数: 0

American Academy of Emergency Medicine 美国急诊医学学会

IF 1.5 4区医学

Journal of Emergency Medicine Pub Date : 2024-06-14 DOI: 10.1016/S0736-4679(24)00209-9

引用次数: 0